Marjon Borgert

43 Standardized measurement of the Modified Early Warning Score Specialty/ward Surgery (Yes/No) Study arm Pre-de ned alteration of protocol, if applicable Exclusion of patients Cardiothoracic surgery Yes Clinically indicated Orthopaedics Yes Clinically indicated Trauma surgery Yes Protocolized After ‘moments at risk’: MEWS measured three times daily for subsequent three days. After three days as clinically indicated unless patient encountered a new moment at risk. Vascular surgery and plastic surgery Yes Protocolized All patients other than those admitted for: all post- ICU patients irrespective of primary diagnosis, all aneurysm of the aorta, surgery for stenosis of the carotid arteries and thrombolytic therapy. Ear, Nose and Throat/ Ophthalmology/ Dermatology Yes (two out of three are surgery) Clinically indicated Neurology No Clinically indicated Neurosurgery Yes Clinically indicated Maternity and delivery ward No Protocolized All surgery patients, MEWS three times daily. Remainder as clinically indicated. Gynaecology Yes Clinically indicated All patients staying one night admitted for chemotherapy only. A description of the 18 included study wards is shown. Primarily, all patients admitted for at least one night are eligible for inclusion. The specialties on the wards are described including whether the ward was primarily denoted as being a surgery type based ward. For ear, nose and throat, ophthalmology and dermatology, the ward was also denoted as surgery because two out of three are primary surgery based. Four wards indicated that some alterations were applicable for patients admitted to these wards. These primarily indicated that not throughout the entire admission, MEWS was to be determined three times daily. Five wards also de ned patient groups speci cally for in- or exclusion. ‘Moments at risk’are de ned as the period (speci cally de ned per specialty/general ward) after admission to the hospital, after receiving surgery and after discharge from ICU/high dependency wards.